How to write a nursing discussion on Rheumatoid Arthritis

How to write a nursing discussion on Rheumatoid Arthritis

Q1. Describe the immunopathogenesis of the joint changes that occur in RA.

Rheumatoid arthritis (RA) is an autoimmune disease that mainly affects joints in the hands, wrists, and knees (Pope, 2020). The pathogenesis of RA is complex because it involves a series of interactions between genetic, environmental, and immunologic factors. It is established that immune cells like anti-citrullinated protein antibodies (ACPAs) and cytokines exist and increase gradually in circulation before RA (Yap et al., 2018). The interaction of these cells in the joints increases vascular permeability in the synovium and activates synovial cells. The result is the activation of small-molecule mediators of inflammation like chemokines and matrix metalloproteinases (MMPs) that initiate arthritis (Yap et al., 2018). The synovial lining is not an effective barrier to preventing disease progression.

Q2. What is the significance of her RF test results?

The rheumatoid factor (RF) test looks for the presence of proteins made by the immune system that may be the source of autoimmune disorders. RF is important to diagnose RA and determine the extent of the disease (Yap et al., 2018). Although not all cases of RA contain RF, individuals with RF-positive results tend to manifest with bone erosion and have a poor prognosis.

Q3. How do her complaints of general fatigue and weight loss related to the RA disease process

Weight loss and fatigue are common symptoms in individuals with RA (Yap et al., 2018). It is established that inflammatory cells like cytokines also impact metabolism and contribute to muscle breakdown. Secondly, RA can decrease appetite leading to insufficient food intake that leads to weight changes. More than three-quarters of patients with RA experience fatigue (Pope, 2020). Fatigue can be a result of pain, sleep disturbance, and depressed mood.


Pope J. E. (2020). Management of fatigue in rheumatoid arthritis. RMD Open6(1), e001084.

Yap, H. Y., Tee, S. Z., Wong, M. M., Chow, S. K., Peh, S. C., & Teow, S. Y. (2018). Pathogenic role of immune cells in rheumatoid arthritis: Implications in clinical treatment and biomarker development. Cells7(10), 161.

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